Impact of assessment of fractional flow reserve and instantaneous wave-free ratio on clinical outcomes of percutaneous coronary intervention: a systematic review, meta-analysis and meta-regression analysis

Aim. To conduct a systematic review and meta-analysis to compare clinical outcomes in patients with coronary artery disease (CAD) undergoing percutaneous intervention (PCI) using conventional angiography (CAG) or fractional flow reserve (FFR)-guided PCI. In addition, FFR-guided PCI guided instantaneous wave-free ratio (iFR) were compared. Material methods. PubMed, Google Scholar databases searched for studies comparing CAD CAG-guided FFR/iFR-guided Dichotomous data analysis was presented as odds (OR) 95% confidence interval (CI). Adjusted hazard (HR) values from similar evaluation criteria pooled meta-analysis. Results. Six randomized controlled trials (RCTs) 184 publications selected this A total of 2193 (mean age, 64,2 years, mean follow-up, 28,0 months) included. Analysis RCTs showed that did not have significant difference the incidence major adverse cardiovascular events (MACE) (OR: 0,78; CI: 0,61-1,00; p=0,05; I 2 =0%), all-cause death 0,86; 0,51-1,44; p=0,57; =0%) emergency revascularization 0,69, 0,46-1,04, p=0,08, =0%). However, associated reduced risk subsequent MI compared 0,70; 0,50-0,99; p=0,04; addition results previous RCTs, we conducted metaanalysis 3 observational studies. total, groups included 165012 11450 patients, respectively. mortality (HR: 0,74; 0,63-0,87; P=0,0003) 0,75; 0,61-0,94; p=0,01). there no between iFRand terms MACE 0,97; 0,76-1,23; p=0,81), 0,66; 0,40-1,10; p=0,11), 0,83; 0,56-1,24; p=0,37) repeated 1,16; 0,85-1,58; p=0,34). Conclusion. is At same time, iFR-guided inferior method rate.